http://leader.pubs.asha.org/article.aspx?articleid=2288217School-Age Stuttering: What Works?What works in school-age stuttering treatment? This question has been asked countless times by speech-language pathologists in all settings. The problem is that it has been answered in countless ways as well. In response, I will address the “Big 4” concepts (listed in no particular order) that guide me in ...2006-09-01T00:00:00FeaturesNina A. Reardon-Reeves

Nina A. Reardon-Reeves, is a board-recognized fluency specialist and mentor who is an itinerant speech-language pathologist in the Dallas, TX area. In her private practice, she specializes in working with children and young adults who stutter. Contact her by e-mail at nina@mtco.com.

Nina A. Reardon-Reeves, is a board-recognized fluency specialist and mentor who is an itinerant speech-language pathologist in the Dallas, TX area. In her private practice, she specializes in working with children and young adults who stutter. Contact her by e-mail at nina@mtco.com.×

What works in school-age stuttering treatment? This question has been asked countless times by speech-language pathologists in all settings. The problem is that it has been answered in countless ways as well.

In response, I will address the “Big 4” concepts (listed in no particular order) that guide me in determining what works in school-age stuttering treatment. Obviously, this is by no means an exhaustive list, but it gives us food for thought and a beginning framework for further enhancement of our skills in treating children who stutter.

1. Know why we are doing what we are doing.

What are the history, theory, and evidence behind what you are doing in treatment? We must be diligent in upholding our ethical standard of providing treatment based on our knowledge and understanding of the principles surrounding our practice.

Our treatment must be based on our knowledge of the disorder of stuttering, our awareness of past and present research in this area, and our understanding of what helps children who stutter. We cannot allow ourselves to become complacent with what we were taught in graduate school or what we heard at a seminar, especially if we have no understanding of the theory or evidence that support the approaches we are using. If we do not understand the reasons why our treatment works (or why it does not), then we cannot troubleshoot, flex, or adapt our treatment to meet the needs of students in our care. Stuttering is different for every child and it affects every child differently. With this knowledge, we understand that children do not fit into strict and regimented treatment programs. We must adjust our plans to fit their needs.

2. Help children understand why they are doing what they are doing.

If we are more effective when we understand the rationale behind treatment philosophies and activities, then, logically, we can postulate that children are more effective in dealing with stuttering when they understand why certain treatments are more or less effective for them.

It is our role to guide people who stutter through the process of stuttering treatment. We do this by discovering with children what works best for them and why (Williams, 1983). A child who stutters and discovers what works best and why will be able to transfer this knowledge to other situations. That child will also be able to use skills flexibly in managing stuttering through life.

The bottom line is this: A child who knows why he is doing what he is doing (using speech and stuttering management tools, dealing with speaking anxieties, attempting communication challenges, etc.) in treatment will be better equipped to use this knowledge in a variety of settings and over the long term.

3. Get to know the whole child, not just the stuttering behaviors.

Stuttering is a communication disorder that can be affected by many factors (Conture, 2001). Considering this, it follows that treatment must not be geared to address only one aspect of the disorder (such as the speech-motor aspect). Children can benefit from a treatment approach that addresses the multifactorial nature of stuttering. This means that we must view treatment as a vehicle to aid children in dealing with the affective, behavioral, cognitive, and social aspects of stuttering (Healey, Trautman, & Susca, 2004). When we view children as complete and complex beings, we begin to develop the positive client-clinician rapport that is so essential in helping children with communication disorders.

4. Provide resources to children and families.

It is important that clinicians understand that they are not alone in helping children who stutter. Many organizations and resources exist with the sole purpose of supporting clinicians who work with stuttering as well as supporting people who stutter and their families. Knowing about these resources and spreading the word about them to the children and families with whom we work will enhance our ability to provide more effective school-age stuttering treatment.

What works in stuttering treatment? The answer lies within each client we encounter. Armed with an understanding of the disorder, a set of clear and flexible guidelines for treatment, a clinician-client rapport that engages us in what the child needs, and a true sense of the resources that keep us current and connected, we can continue to move forward in our abilities to provide more effective treatment for school-age children who stutter.

Focus on Divisions

Division 4, Fluency and Fluency Disorders, focuses on professional and research topics related to the fluency and fluency disorders. The division offers Perspectives, an exclusive e-mail list; Web forum; and other benefits. Visit the ASHA Web site to learn more about Division 4.